How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $114.82 Median $3,801.89 Typical High $5,623.41 | Facility | None | $114.82 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $213.80 | Professional | None | $114.82 | $169.82 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $251.19 | Professional | None | $120.23 | $177.83 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $269.15 | Facility | None | $138.04 | $138.04 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $199.53 Typical High $338.84 | Facility | None | $66.07 | $199.53 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $295.12 | Professional | None | $125.89 | $186.21 | $295.12 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $1,288.25 | Facility | None | $239.88 | $346.74 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $302.00 | Professional | None | $151.36 | $229.09 | $302.00 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $309.03 | Professional | None | $125.89 | $181.97 | $309.03 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $57.54 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $22.91 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $85.11 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $16.98 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.48 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $79.43 | $112.20 | $134.90 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 37th of 51
$191
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.